Get the free CO-MANAGEMENT AGREEMENT FORM Cataract Surgery

Thomas Wyman, MD Catherine Cuite, MD Evan Pike, MD Thomas Kirchgessner, OD Sarah Salim, OD, MPH 8921 N Wood Sage Rd Peoria IL 61615Pete Lagouros, MD Yannis Kolettis, MD Edward Hu, MD, PhD Jacqueline

How to fill out co-management agreement form cataract

How to fill out co-management agreement form cataract

1. Obtain the co-management agreement form for cataract surgery from the appropriate source, such as the hospital or surgical center.
2. Fill out the patient's personal information, including name, address, date of birth, and contact information.
3. Provide details of the cataract surgery, such as the date of surgery, name of the surgeon, and location of the procedure.
4. Include information about the co-managing optometrist or ophthalmologist, their contact information, and their role in the patient's care.
5. Review the form for accuracy and completeness before signing and submitting it to the appropriate party.

Who needs co-management agreement form cataract?

1. Patients undergoing cataract surgery who are receiving care from both a surgeon and an optometrist or ophthalmologist may need to fill out a co-management agreement form.

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What is co-management agreement form cataract?

A co-management agreement form for cataract is a legal document that outlines the shared responsibilities between an ophthalmologist and a referring eye care provider for the surgical treatment and post-operative care of a patient undergoing cataract surgery.

Who is required to file co-management agreement form cataract?

Both the referring eye care provider and the ophthalmologist involved in the patient's care are required to file the co-management agreement form for cataract surgery.

How to fill out co-management agreement form cataract?

To fill out the co-management agreement form for cataract, both parties need to provide their names, contact information, the patient's details, the type of cataract procedure, and specific terms regarding the responsibilities for pre-operative and post-operative care.

What is the purpose of co-management agreement form cataract?

The purpose of the co-management agreement form for cataract is to ensure clear communication and a shared understanding of roles, responsibilities, and expectations between the eye care professionals involved in a patient's cataract treatment.

What information must be reported on co-management agreement form cataract?

The co-management agreement form must report the names of the involved providers, patient identification details, the nature of the cataract surgery, and the agreed-upon division of responsibilities for care before and after the surgery.